Before Sarah Grenberg gave birth to her first child, she learned that the image of a sleeping infant in a sea of blankets, stuffed toys and pillows is far from the ideal.
"You always see pictures of baby stuff advertised, and there's all these toys in there and blankets," the Duluth woman said. "So I was like, 'Oh, really, nothing in there?' when I first learned."
Grenberg, who took an infant CPR and safety class while pregnant, was at the St. Luke's hospital birthing center on Wednesday with her baby, 2-month-old Dylan, who starred for the cameras in a news conference designed to call attention to the urgency of safe-sleep practices for infants.
"Unsafe sleep environments account for the vast majority of all unexpected infant deaths in Minnesota," said Susan Castellano, maternal and child health director for the Minnesota Department of Health.
The news conference took place because Gov. Mark Dayton has proclaimed this to be Safe Sleep Week in Minnesota. It was in Duluth because St. Luke's was the first hospital in the state to earn the National Safe Sleep Hospital Certification from Kids for Cribs, a Pittsburgh-based nonprofit.
That distinction actually came in June 2016 and resulted from hospital personnel looking at safe sleep practices as its birthing center was being renovated, said Lori Swanson, maternal child health nurse manager for St. Luke's.
They realized existing practices didn't meet current standards, she said.
"(Newborns) were out in cribs with those beautiful gifts from the gift shop, sidled right up next to them," Swanson said. "There were beautiful loose blankets, and there were stuffed animals up next to those babies, balloons tied to the end of the bassinet."
Instead, as Stephanie Forslund, clinical supervisor in the birthing center, illustrated with Dylan, the best practice is for the infant to sleep alone in a crib and instead of blankets to be in a "sleep sack," which is wrapped around the baby's body with nothing around to create a possible suffocation risk.
St. Luke's uses the sleep sacks in the birthing center and sends each family home with one for their baby, Forslund said.
The hospital also educated its staff in infant safe sleeping, changed its policies and worked on modeling safe practices for the parents of newborns, Swanson said.
A state health department analysis of sudden unexpected infant deaths from 2015 points to the importance of safe sleep, Castellano said. Of the 54 deaths analyzed, 53 happened in unsafe sleep environments, she said.
The push for improved practices comes as the state's infant mortality rate has hovered for a number of years around 5 deaths in the first year of life per 1,000 live births, specifically 5.1 in 2016. That's somewhat better than the national rate, but the national rate is worse than in most developed countries, according to data from the CIA World Factbook.
Castellano offered a possible explanation for that.
"The other countries that have better rates than we do, they've got very family-friendly policies," she said. "Most women take a year off (after giving birth), so they're able, I think, to better care for their infants. There's a lot of research to show that that time off with baby is a huge factor."
The rates in Minnesota for sudden unexpected infant death are worse for some ethnic groups than others, Castellano said - twice as high for African Americans and Native Americans as for the general population.
"It's important to acknowledge that a family's social and economic factors may make it difficult for them to have a reliable and safe place to sleep for their infants," she said. "The data suggest that Minnesota health and racial inequities are preventing some babies from having the opportunity for a healthy start, and that includes a safe sleep environment."
ABCs of safe sleep
• Alone: Infants should always sleep or nap alone.
• Back: Always put a baby on its back to sleep or nap.
• Crib: Babies should always nap in their own safety-approved crib or play yard.
Source: Minnesota Department of Health